Childhood Obesity: PICOT Analysis

The problem of childhood obesity.

Childhood obesity is one of the public health priorities associated with metabolic impairments in peripheral tissues. Obesity can be described as state where there is an extremely excessive amount of body fat or adipose tissue in relation to lean body mass Body mass index (BMI) (Tumova, J., Andel, M., & Trnka, J., 2016). The increase in the occurrence of childhood obesity in the United States is continually well documented and the surveillance estimates is about 12.5 million obese children and adolescent. Long-term predictions of outcomes of obesity epidemic include a decline in population health as the disease and debility alongside substantial societal and economics costs (Eyler, A. A., Nguyen, L.,

Kong, J., Yan, Y., & Brownson, R., 2012).
The relevance of obesity to my area of specialization
As a family nurse practitioner, my role is to educate and engage all my patients in their own care while providing a high-level of care to them.

Children are unable to care for themselves so they rely on their parents to provide the necessary care until they are able to do so. In a lot of ways, my role will be to educate parents to care for themselves and their families whenever the opportunity arises. I believe that I could make positive changes in the lives and teach parents or families according to evidence base, that they will implement positive lifestyle changes to prevent obesity (Hessler, K. L., 2015).

PICOT Question

In primary care children and adolescents 9 and older (P), will the body mass Index (BMI) and waist circumference (WC) (I) at each visit (C) reduce the prevalence (O) of obesity (T)?

The conceptual model chosen

The model chosen for this project is the Model for Evidence-Based Practice Change. The model consists of important guidelines tools in Evidence-based practice (EBP) that can reduce healthcare variation and improve patient outcomes (Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E., 2014). Evidence-based practice (EBP) is a problem-solving method to the delivery of health care as it combines the best evidence from well-design studies and evidence-based theories with expertise of the clinician and a patient’s preferences, values to make the best clinical decisions (Melnyk, B. M., et al. 2014). The model consists of seven steps of

EBP process and facilitating elements.
• Cultivate a spirit of inquiry along with an EBP culture and environment.
• Ask the PICO(T) question. This assesses the need for change in practice; identify the problem with an opportunity for an improvement.
• Search for the best evidence. This locates the best evidence using search strategies such as CINAHL, Pubmed, Medline, Cochrane and Trip Database.
• Critically appraise the evidence. This critically analyzes the evidence for validity, reliability, and applicability and determines if the body of evidence is of sufficient quantity and strength to support a practice change.
• Integrate the evidence with clinical expertise and patient preferences to make the best clinical decision. Integrate, Incorporate, and maintain a change in practice.
• Evaluate the outcome(s) of the EBP practice change to determine its impact.
• Disseminate the outcome(s) to allow others to learn of practices that has yielded best results.
In conclusion, this EBP using the PICO question will be assessing BMI and WC measurements to identify individuals who are overweight or obese, then raise awareness of their weight status educating them on the health risks.

References
Eyler, A.

A., Nguyen, L., Kong, J., Yan, Y., & Brownson, R. (2012). Patterns and Predictors of Enactment of State Childhood Obesity Legislation in the United States: 2006–2009. American Journal of Public Health, 102(12), 2294–2302. http://doi.org/10.2105/AJPH.2012.300763

Hessler, K. L. (2015). Self-efficacy and knowledge of nurse practitioners to prevent pediatric obesity. The Journal for Nurse Practitioners, 11(4), 402-408. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1016/j.nurpra.2015.01.026

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of Evidence‐Based practice competencies for practicing registered nurses and advanced practice nurses in Real‐World clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15. doi:10.1111/wvn.12021

Robertson, W., Murphy, M., & Johnson, R. (2016). Evidence base for the prevention and management of child obesity. Paediatrics and Child Health, 26(5), 212-218. doi:10.1016/j.paed.2015.12.009

Tumova, J., Andel, M., & Trnka, J. (2016). Excess of free fatty acids as a cause of metabolic dysfunction in skeletal muscle. Physiological Research, 65(2), 193-207. Retrieved from

http://search.proquest.com.southuniversity.libproxy.edmc.edu/docview/1798384458?accountid=87314